666 Election Soapbox: Health

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Joining Adam in the studio:

Dr Rashmi Sharma , ACT Medicare Local

Kerry Snell , Health Care Consumers association of the ACT

Russell McGowan, ACT branch of the Public Health Association

Adrian Watts, West Belconnen Health Co-Op

Rohan Greenland, Heart Foundation

Julie Tongs, Winnunga Health

Frank Quinlan, Mental Health Council

The wellbeing of the community is always a strong issue at an election and the cost of healthcare continues to increase.

Russel McGowan told Adam that health services are a work in progress.

McGowan explained that preventative medicine is an important part of the whole.

"If you don't get it early then you have more problems to deal with, with the limited resources you have.

Over the course of the forum it became clear that coordination of care services delivers solid outcomes.

"A lot of it is to do with the connectedness of care. One of my passions in the last little while has been introducing better mechanisms for connecting care...it's about not falling through the cracks. Not having to continually repeat your story," McGowan added.

Primary health care

How we deliver primary health care is changing. Recently Medicare Locals have been set up by the Government to manage access to health services at a local level.

Dr Rashmi Sharma explained that these were not brand new to Canberra and that the function was greatly about coordinating services.

"Let's get the whole team working together better and also lets support the whole team, because by and far they are private businesses... that don't necessarily connect that well together and [don't] have a lot of support."

Dr Sharma underscored some of Canberra's particular concerns.

"We do have pockets of disadvantage. We've got areas of the ACT where the immunisation rate is well below the national average... [and] the obesity epidemic that we are facing in the ACT with numbers of children in kindergarten being overweight now," she explained.

Rowan Greenland agrees there is work to be done in obesity and physical inactivity.

"While we've done incredibly well with tobacco control we have a much poorer approach to these issues," he told Adam.

Greenland called for increased emphasis on public health.

"When the health reform process began under then Prime Minister Rudd, [he] actually said that investing [only] two percent of our national health care spend on public health was crazy. We're now down to 1.7 percent."

"There is a lot of debate about what interventions work best, but we'd like to see some interventions go ahead, to be well funded, to be supported, and you learn as you go," he added.

The West Belconnen Health Co-op is taking a different approach to primary care, moving into a low socio-economic area that suffered from a lack of health professionals, and it's grown.

"There was one doctor supporting 10,000 residents. Our model is different...it's a community owned practice, not for profit, owned and run for its members and open to everyone," explained Adrian Watts.

The lower cost for patients visiting the co-op goes some way to the holy grail of universal healthcare, and Dr Sharma told Adam that the GP shortage of some years ago has also eased.

"We've recently released a workforce study that shows our number of GPs per head of populations is equivalent to the rest of the country now."

Indigenous health

Closing the gap on indigenous health remains one of the greatest challenges for government and health policy.

Winnunga Health's Julie Tongs told Adam that the Closing the Gap initiative is providing staff to boost the broad range of services the 25 year old organisation provides, a service that is already quite well networked, but with a challenge none the less.

"We see very complex, vulnerable and challenging clients," she told Adam. "Winnunga often gets overlooked because ACT is a small jurisdiction, but we've got a large region... We've got a mobile population; we've got a transient population."

The greatest challenge for Winnunga is in the area of mental heath.

"One mental health nurse and a part time psychiatrist and a psych registrar isn't enough," she added.

Kerry Snell told Adam about her personal experience with aged care, with both her parents suffering from Parkinson's Disease.

She welcomes recent government initiatives, but feels more can be done.

"The rationalisation of aged care funding is not great. There aren't enough home care packages or residential care packages for people. That's only going to be an increasing problem."

Snell points out the difficulties in coordination that the sector faces as aged care patients move between institutions like care facilities and hospital.

"It's very complex [health care], not sexy. There's a continual overturning of staff... and [an] inadequate ratio of nurses and carers. I'd like to see that legislated," she added.

Mental health

The government announced $2.2 billion for health care over five years and Adam asked the panel if there had been positive change flowing from the funding.

Frank Quinlan told Adam that it was a fantastic injection of funds.

"Part of the problem...is that the numbers sound so big when we talk about two billion dollars, but when we talk about the whole Australian population...and a base where that means people simply aren't getting the services they need; then it's only the start of a journey. We're heading in the right direction, but we've got a long way to go."

Quinlan agreed that connected services is important for mental health patients as well, as so much of their recovery is facilitated by help other than that provided by the mental health system.

"If people are going to successfully overcome mental illness they're going to need access to services like housing and employment. They're going to need health care professionals to take extra care that their diabetes and heart conditions are monitored," he added.

Connection

Adam put to the panel that the emerging theme was in the area of connection, an aspect that's developing but that seems to be the pathway to improved coordinated services.

"A lot of the issues of unconnectedness to date have been that we haven't had a bottom-up approach to designing our systems. It's been a top-down approach so you've disengaged the workforce that is involved in service delivery... It's not all bad news. We are making headway but there's always room for improvement," Dr Shrama pointed out.

McGowan pointed out that problems still exist with funding models that similarly lack integration.

"[Part of the solution is] Getting the funding right and not relying solely on fee-for-service funding, but funding for health outcomes. For wellness, not just illness."